UMT/PPBA/J01 (Pin.

1/2015)

APPLICATION FOR ACADEMIC POSITION

GENERAL INFORMATION: Please read the following before completing the application form
1.

The information given in this form must be completed and clearly filled.

2.

Candidate can only apply for one post per application.

3.

Please provide a certified true copy of :i)

Identification Card or Passport;
ii)
Academic certificates (SPM/bachelor/master/PhD);
iii)
Co-curricular certificates;
iv)
Latest Annual Work Performance Report (LNPT) (government servant);
v)
Latest Services Statement (government servant);
vi)
The last drawn salary;
vii)
Testimonials; and
viii)
A comprehensive resume including list of teaching, research, publication and
consultation activities. Please submit proof of your publications.

4.

Application from government servants (Malaysians only) shall be submitted through their Head
of Department who shall forward the application to us together with the required particulars of
service and comments by the Head of Department.

5.

Application received after the closing date, or is incomplete or is without a copy of the
IC/Certificates/ Diploma/Degree/relevant documents will not be entertained.

6.

Only qualified and short-listed candidates will be called for an interview. The University is not
responsible for any expenses incurred in the process of attending the interview.

7.

Applicants who do not receive any response after six (6) months from the closing date of this
advertisement/application, shall assume that their application is unsuccessful.

8.

The University will not pay any expenses incurred for this application or for attending interview.

9.

Please state the position, name of the faculty and field of interest applied on the top left corner
of the envelope and submit your application to :-

Completed forms should be sent to:

PUSAT BAKAT DAN INOVASI AKADEMIK
UNIVERSITI MALAYSIA TERENGGANU
21030 KUALA TERENGGANU
TERENGGANU DARUL IMAN
MALAYSIA
(U.P. SEKSYEN PEMBANGUNAN BAKAT AKADEMIK)

UMT/PPBA/J01 (Pin. 1/2015)

UNIVERSITI MALAYSIA TERENGGANU
PUSAT PENGURUSAN BAKAT AKADEMIK
21030 Kuala Terengganu, Terengganu Darul Iman
Tel. : 09-668 4879 Faks : 09-668 4331

Please attach a
recent passport
size photograph
here

ACADEMIC JOB APPLICATION FORM

A. APPLICATION FOR THE
POSITION OF:

Position :
School/Institute :
Field :

B. PERSONAL DETAILS
1. Full Name (Capital Letter)

2. Gender :

Male

Female

3. Religion :

4. Race :

5. Date of Birth
(dd/mm/yy) :

6. Identification No. /
Passport No. :

7. Age :

8. Marital Status :

9. No. Of Children (If Any)

:

10. Nationality :

Single

Married

11. Origin Country: ____________________________

C. CONTACT INFORMATION
1. Primary Email :
4.
Address :

Postal

2. Mobile No. :

3. Office
No. :

Postal Code

City

State/Region

Country

Telephone

D. EDUCATIONAL QUALIFICATIONS
1. University/Institute/Schools Attended (SPM/Bachelor/Master/PhD)

UMT/PPBA/J01 (Pin. 1/2015)

Type of Certificate/
Diploma/Degree

Field of Study

Grade/
CGPA

School/Institute/University

Graduation
Date

2. Publication
a)

Jurnal
(Please use extra sheet if needed)
Year
Title of article in jurnal

b) Proceeding
(Please use extra sheet if needed)
Year
Title of article in jurnal

3. Professional Certification (Optional) e.g. Certified

Public Accountant
Certificate Name

Year Obtained

Status
(ISI/SCOPUS)

Author/CoAuthor/
Corresponding
Author

Quantum
(Q1,Q2,Q3,Q
4)

Status
(ISI/SCOPUS)

Author/CoAuthor/
Corresponding
Author

Quantum
(Q1,Q2,Q3,Q
4)

4. Language Proficiency
State your Bahasa Melayu and English Test Result
during SPM and MUET.
Type Language
Grade
Year
Bahasa Melayu (SPM)
English (SPM)
English (MUET)

5. Scholarship/Academic Awards (If

Any) :
6. Contract Agreement (If Any)
Please state the period of the contract and
the name of the contract owner :
E. JOB EXPERIENCE
1. Current Job
Position
Organization Name

Date
Appointed

Gross
Salary Per
Month

Salary
Grade

Organization Address/postal
code
Telephone No.

2. Previous Job

Fax No.

Salary Increment
Date

EPF/ Pension
No.

UMT/PPBA/J01 (Pin. 1/2015)

Position

Company Name

Date
Start

Date End

Monthly Salary

F. CO-CURICULLAR ACTIVITIES

Name of Activities

Level of Achievement
(National/State/University/School)

G. REFERENCES
References must not a relative with the applicant and he/she can describe about applicants academic qualification.
REFERENCE 1

REFERENCE 2

Name

Name

Relationship

Relationship

Telephone No.

Telephone No.

Email

Email

Position

Position

Company Name

Company
Name

H. WORKING AVAILABILITY

I can start work after ____ month(s)

of notice period.

I can start work after _____________

(dd/mm/yy)

I can start work immediately

I. DECLARATION

Hereby I admitted as follows :-

Yes

No

If yes, please mention the details.

1. Did you apply any job in UMT?

2. Do you have any criminal record?
3. Are you a drug addict?
4. Have you been dismissed from any government
bodies?

I hereby declare that all of the statements that have been filled in this application are true. If any
of the statement is false or the application is incomplete, UMT is entitled to revoke the approval of
this application.
Signature:

Date :

UMT/PPBA/J01 (Pin. 1/2015)

UNIVERSITI MALAYSIA TERENGGANU

PUSAT PENGURUSAN BAKAT AKADEMIK
21030 Kuala Terengganu, Terengganu Darul Iman
Tel. : 09-668 4879 Faks : 09-668 4331

CONFIDENTIAL REPORT FOR AN ACADEMIC POSITION

Section A : To be Completed by the
Applicant
Name of Applicant

Identification/Passport No.

Position Applied

Name of Referee

Referee s Position

Referees Organization
Name

School/Institute :

Section B : To be Completed by the

Referee
The above mentioned applicant has applied for a position at Universiti Malaysia Terengganu. The
applicant is required to obtain confidential report from referees of his/her own choice and the
report to be submitted directly to Universiti Malaysia Terengganu together with the application
form.
Please provide the required confidential report with reference to the qualification and suitability
of the applicant to hold the position. The evaluation required by the university should include
excellence in knowledge, education acquired, potential expertise for further development, ability
to teach and conduct experimental studies, experience, personality and other relevant aspects
which will assist the university college to assess his/her application.
If the space provided is insufficient, please submit the report as a separate document.
1. How long and in what capacity have you known the applicant?

2. Please discuss the applicants ability and suitability for the position he/she is
applying for.

UMT/PPBA/J01 (Pin. 1/2015)

3. Please provide your views on the applicants qualities in the following areas : (Use
additional sheet if necessary)
Academic Qualifications

Leadership Qualities

Willingness to Cooperate

Personal Qualities

4.

Based on the above, would you recommend the applicant to the position he/she is
applying for?

Signature

Date

Name of Referee

Position

Identification/Passport
No.

Name of Institution

Office Address

Office Telephone No.

Fax No.

Thank you for your kind cooperation.

Please send the completed report together with the application form in a separate envelope to :PUSAT BAKAT DAN INOVASI AKADEMIK
UNIVERSITI MALAYSIA TERENGGANU
21030 KUALA TERENGGANU
TERENGGANU DARUL IMAN
MALAYSIA
(U.P. SEKSYEN PEMBANGUNAN BAKAT AKADEMIK)

UMT/PPBA/J01 (Pin. 1/2015)

UNIVERSITI MALAYSIA TERENGGANU

PUSAT PENGURUSAN BAKAT AKADEMIK
21030 Kuala Terengganu, Terengganu Darul Iman
Tel. : 09-668 4879 Faks : 09-668 4331

CONFIDENTIAL REPORT FOR AN ACADEMIC POSITION

Section A : To be Completed by the
Applicant
Name of Applicant

Identification/Passport No.

Position Applied

Name of Referee

Referee s Position

Referees Organization
Name

School/Institut
e:

Section B : To be Completed by the

Referee
The above mentioned applicant has applied for a position at Universiti Malaysia Terengganu. The
applicant is required to obtain confidential report from referees of his/her own choice and the
report to be submitted directly to Universiti Malaysia Terengganu together with the application
form.
Please provide the required confidential report with reference to the qualification and suitability
of the applicant to hold the position. The evaluation required by the university should include
excellence in knowledge, education acquired, potential expertise for further development, ability
to teach and conduct experimental studies, experience, personality and other relevant aspects
which will assist the university college to assess his/her application.
If the space provided is insufficient, please submit the report as a separate document.
1. How long and in what capacity have you known the applicant?

2. Please discuss the applicants ability and suitability for the position he/she is
applying for.

UMT/PPBA/J01 (Pin. 1/2015)

3. Please provide your views on the applicants qualities in the following areas : (Use
additional sheet if necessary)
Academic Qualifications

Leadership Qualities

Willingness to Cooperate

Personal Qualities

4.

Based on the above, would you recommend the applicant to the position he/she is
applying for?

Signature

Date

Name of Referee

Position

Identification/Passport
No.

Name of Institution

Office Address

Office Telephone No.

Fax No.

Thank you for your kind cooperation.

Please send the completed report together with the application form in a separate envelope to :PUSAT BAKAT DAN INOVASI AKADEMIK
UNIVERSITI MALAYSIA TERENGGANU
21030 KUALA TERENGGANU
TERENGGANU DARUL IMAN
MALAYSIA
(U.P. SEKSYEN PEMBANGUNAN BAKAT AKADEMIK)